Consumer Reports: 'A World of Pain' For Uninsured Seeking Insurance on Their Own

... Third Report About America's Health Care Crisis With 6 Tips For Bu...YONKERS N.Y. Dec. 3 -- Consumer Reports'yea...According to research cited in the report 89 percent of people wholo...FIXING THE PRIVATE INSURANCE MARKET: THE HURDLES ...

YONKERS, N.Y., Dec. 3 /PRNewswire-USNewswire/ -- Consumer Reports'
yearlong investigation into health insurance explains the huge hurdles that
consumers, including healthy people with minor ailments, face when they try
to acquire health insurance on their own.

According to research cited in the report, 89 percent of people who
looked into buying individual insurance had not bought it because it was
too costly, they were turned down for health reasons, or it provided
inadequate benefits. The report, "On their Own," is featured in the January
issue of Consumer Reports, on newsstands December 4 and available online at
http://www.ConsumerReports.org/health where CR maintains a health insurance
hub for consumers. The report is the third in a series on America's health
care crisis.

FIXING THE PRIVATE INSURANCE MARKET: THE HURDLES

"What we've learned in our investigation is that private insurance is
virtually out of the question for most uninsured Americans -- 76 percent to
be precise -- and those who do manage to acquire insurance on their own
tell us wrenching stories about the high costs and poor coverage they
receive," said Nancy Metcalf, health editor at Consumer Reports. People in
need of private insurance face a daunting dilemma--buying limited health
insurance at a high cost or foregoing insurance altogether. Who could fall
into this category? Any adult who hopes to retire early, loses a job, is
self-employed, or has an adult child leaving a group plan.

CLOSE UP: INDIVIDUAL COVERAGE, MORE COMPLAINTS

Source: Consumer Reports National Research Center

INDIVIDUAL PLAN EMPLOYER PLAN

Overall complaints with coverage 71% 53%

Insurance covered most costs 55% 81%

Premium is too high 52% 29%

Postponed needed medical care

because of costs 45% 31%

Deductible is too high 41% 28%

Does not adequately cover costs of

doctor visits 26% 16%

According to Metcalf, the latest nationally representative survey
conducted by the Consumer Reports National Research Center underscores the
level of discontent of the 7 percent of Americans who manage to obtain
individual coverage. "If we're going to rely on individual insurance to fix
our health care system, it needs a major overhaul," continued Metcalf.

DISQUALIFYING MEDICAL CONDITIONS

The "world of pain" described in the Consumer Reports investigation
hones in on the enormous differences that exist in state regulations of
individual insurance plans. A person who could easily buy insurance in one
state could be shut out of the market in another. Most striking is the long
list of health conditions that could result in being declined coverage,
even for such common conditions as hay fever and acid reflux.

Medical underwriting, a practice in which insurers can reject people
with illnesses, is the reason why, explains CR. Michael Miano, profiled in
the report, learned that he was uninsurable because he had diabetes.
Miano's case represents one of the most significant problems in the
individual insurance market. While it's illegal for insurers to
discriminate against people in group plans because of their health, medical
underwriting is allowed in all but a handful of states.

Several presidential candidates propose tax incentives for people to
buy individual insurance. Consumers Union, the nonprofit publisher of
Consumer Reports, opposes that approach because it does nothing to fix the
underlying problems, such as medical underwriting, and the tax breaks
wouldn't be enough to make insurance affordable for people with lower
incomes.

Other candidates propose to expand coverage by bringing more people
into the risk pools, by, among other things, requiring insurers to cover
everyone regardless of health history, and subsidizing premiums for
lower-income consumers. Consumers Union believes that those are more
promising approaches, so long as they are coupled with vigorous efforts to
control costs, eliminate waste, and encourage better coordination of care
for chronic conditions.

Be Careful Leaving a Plan: Consumers should be sure to exercise their
rights under the federal Health Insurance Portability and Accountability
Act (HIPAA).

Research the Market: Check out http://www.ehealthinsurance.com, a
reputable Web site with links to hundreds of individual plans nationwide.
Consumers should also check their state's insurance department Web site,
which might have a list of companies licensed to sell insurance.

Get Adequate Benefits: Consumers should make sure that any policy they
buy covers everything that is "medically necessary" for any health problem,
including emotional disorders.

Look Beyond The Premium: The real costs of an insurance plan include
the monthly premium, the annual deductible, and the copays for office
visits and prescription drugs.

Keep Looking: Thirty-four states maintain high-risk pools for people
who can not pass medical underwriting--though consumers can't count on
hearing about that from a broker or private insurer.

JANUARY 2008

The material above is intended for legitimate news entities only; it
may not be used for commercial or promotional purposes. Consumer Reports(R)
is published by Consumers Union, an expert, independent nonprofit
organization whose mission is to work for a fair, just, and safe
marketplace for all consumers and to empower consumers to protect
themselves. To achieve this mission, we test, inform, and protect. To
maintain our independence and impartiality, Consumers Union accepts no
outside advertising, no free test samples, and has no agenda other than the
interests of consumers. Consumers Union supports itself through the sale of
our information products and services, individual contributions, and a few
noncommercial grants.

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